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Should You Do a Breast Self-Exam?

Medically Reviewed by Brunilda Nazario, MD on September 12, 2022

It’s a good idea to get to know what’s normal for your breasts.  That way, you can check with your doctor if you notice something unusual, such as a lump, skin change, or discharge.

But should you do a regular breast self-exam?

While self-exams can help you get familiar with how your breasts usually look and feel, doctors don't necessarily recommend them as a tool to help look for breast  cancer. Studies have shown that they don’t lower your chances of dying from breast cancer and may raise the risk of unnecessary biopsies. They're no substitute for regular mammograms.

But they may be helpful if you're at high risk of breast cancer. They may also provide peace of mind if you're in an age group in which annual mammograms aren't recommended – under 45 or over 55. Ask your doctor whether self-exams are a good idea for you.

What Is a Breast Self-Exam?

It’s a way for you to check your breasts for changes, such as lumps or thickenings. You’ll look at and feel both breasts. If you notice anything unusual, tell your doctor right away. In many cases, those changes aren’t cancer, but you need to see your doctor to find out.

Who Should Do a Breast Self-Exam?

Doctors may recommend that people with a strong family history of breast cancer do monthly self-exams starting at age 20. You can continue for the rest of your life, including during menopause and pregnancy.

Anyone with breast tissue can get breast cancer, though studies of cisgender people (those whose gender identity matches the gender they were assigned at birth) show that women are 100 times more likely to get it than men.

Breast cancer can also affect:

Transgender men. If you haven’t had top surgery (subcutaneous mastectomy) to remove breast tissue, doctors recommend getting yearly mammograms after age 40. You can do breast or chest self-exams between screenings. If you've had top surgery or hormone therapy, self-exams can help you get to know what your "new normal" looks and feels like so you can be alert for any changes.

Transgender women. Using hormone therapy with estrogen or progestin for 5 or more years raises your risk for breast cancer. In this case, doctors recommend getting a mammogram every 2 years after you turn 50.  Breast implants don’t increase your odds for breast cancer, though they can make mammography more difficult. But breast self-exams can help you get used to your changed body and look for changes.  

Nonbinary people. Nonbinary people who were born with female reproductive organs and haven't had top surgery should follow screening guidelines for cis women. If you had breast tissue removed, you may need ultrasounds or focused MRIs instead of mammograms. 

Men. If you're a cis man and breast cancer runs in your family, ask your doctor whether it makes sense to do a monthly self-exam. Breast cancer is more common among men between ages 60-70.

What Should I Look for in a Breast Self-Exam?

If you get regular periods, the best time to do a breast self-exam is after your period. Your breasts are less likely to be swollen, lumpy, or tender at that time.

If you don’t get a period or have irregular ones, pick a day of the month that you’re unlikely to forget and do it then. It should only take you a few minutes.

Look for:

  • Any changes in your breasts, including their look, feel, or size
  • Changes in how your nipples look or feel
  • Dimpling or puckering on the breast skin
  • Hard or thick lumps underneath the breast skin or deep within the tissue
  • Pain in one breast or one spot
  • Fluids or discharge from a nipple
  • Nipple or other parts of your breast pulling inward
  • Rashes in or around your breast
  • Swelling in one or both breasts
  • Warmth, redness, or dark spots on one or both breasts

How Do I Do a Breast Self-Exam?

The techniques for a self-exam are similar for everyone. If you choose to do one, follow these steps:

In the mirror:

  1. Stand undressed from the waist up in front of a large mirror in a well-lit room. Look at your breasts. If they aren’t equal in size or shape, that’s OK! Most aren't. With your arms relaxed by your sides, look for any changes in size, shape, or position, or any skin changes. Look for any puckering, dimpling, sores, or discoloration.
  2. Check your nipples and look for any sores, peeling, or change in their direction.
  3. Place your hands on your hips and press down firmly to tighten the chest muscles beneath your breasts. Turn from side to side so you can look at the outer part of your breasts.
  4. Then bend forward toward the mirror. Roll your shoulders and elbows forward to tighten your chest muscles. Your breasts will fall forward. Look for any changes in their shape or contour.
  5. Now, clasp your hands behind your head and press your hands forward. Again, turn from side to side to inspect your breasts' outer portions. Remember to look at the border underneath them. You may need to lift your breast with your hand to see it.
  6. Check your nipples for discharge fluid. Place your thumb and forefinger on the tissue surrounding the nipple and pull outward toward the end of the nipple. Look for any discharge. Repeat on your other breast.

In the shower:

  1. Feel for changes in the breast. It helps to have your hands slippery with soap and water, especially if you don't have much breast tissue. Check for any lumps or thickening in your underarm area. Place your left hand on your hip and reach with your right hand to feel in the left armpit. Repeat on the other side.
  2. Check both sides for lumps or thickenings above and below your collarbone.
  3. With hands soapy, raise one arm behind your head to spread out the breast tissue. Use the flat part of your fingers from the other hand to press gently into the breast. Follow an up-and-down pattern, moving from bra line to collarbone. Continue the pattern until you have covered the entire breast. Repeat on the other side.

Lying down:

  1. Lie down and place a small pillow or folded towel under your right shoulder. Put your right hand behind your head. Place your left hand on the upper portion of your right breast with fingers together and flat. Body lotion may help to make this easier.
  2. Think of your breast as a face on a clock. Start at 12 o'clock and move toward 1 o'clock in small circular motions. Continue around the entire circle until you reach 12 o'clock again. Keep your fingers flat and in constant contact with your breast. When the circle is complete, move in 1 inch toward the nipple and complete another circle around the clock. Continue in this pattern until you've felt the entire breast. Make sure to feel the upper outer areas that extend into your armpit.
  3. Place your fingers flat and directly on top of your nipple. Feel beneath the nipple for any changes. Gently press your nipple inward. It should move easily.
  4. Repeat these steps on your other breast. Don’t forget to check the upper, outer area of the breast, nearest to the armpit.

What Should I Do if I Find a Lump?

Don’t panic. It could be many things other than cancer. But do check in with your doctor’s office if you notice any new breast changes, such as:

  • An area that is different from any other area on either breast
  • A lump or thickening in or near the breast or in the underarm that lasts through your menstrual cycle
  • A change in the size, shape, or contour of the breast
  • A mass or lump
  • A marble-like area under the skin
  • A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly, or inflamed)
  • Bloody or clear fluid discharge from the nipples
  • Redness of the skin on the breast or nipple

Show Sources

SOURCES:

American Cancer Society: “Frequently Asked Questions About the American Cancer Society’s Breast Cancer Screening Guideline.”

Cleveland Clinic: “Breast Self-Exam.”

National Women’s Health Network: “How Often Should I Be Giving Myself a Breast Exam as a Transgender Woman?”

Maurer Foundation: “How Does Sex Reassignment Surgery Affect Breast Cancer Risk Factors?”

Illinois Department of Public Health: “Self Screening.”

Monmouth Medical Center: “Why Do a Breast Self Exam?”

Mayo Clinic: “Top surgery for transgender men and nonbinary people.”

Michigan Health: "Should You Do Self Breast Exams?"

American College of Obstetricians and Gynecologists.

U.S. Preventive Services Task Force.

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